PRE 2010 DOCS0 City oFridley, f FridlMinn •
BUILDING PERMIT No 4104
Date: .................._.......... --•---..........---•------....._..._........_...---•-• •---••---_....---...---•-------
Owner:....._............._....---..........---....---•----------..............._.--•-------------------------:- . Builder - ... ...- - !.� -••••--.._....._.._..... s.._ �._
Address.....-............._..------..._.........----...._.._...._.......__._..._. ............ Address ............... ........................... _...................... _......_------------
_..._.._.._..--_....
54-441_ LOCATION OF BUILDING
No. � Street .............. // w�.. Part of Lot .................................. .... ............................
Lot Block _.. . Q ............ Addition or Sub -Division ....................._..._._....._....
Sr
Corner Lot .........X ................... Inside Lot ....................................... Setback -. +...._.........._.. eyard ..../....#.----------........._....----•--•----•----••.
Sewer Elevation --------........._ .R ............... „-.-.....................
�../...P---/..�Foundation ElevationC1 7,t ---Y
t -..Y._.. --r---
......................................
DESCRIPTION OF BUILDING
To be Used as:
_ ......... Front . ...s40 Depth LP..`.�.) Height 0.....1..E Sq Ft. Ft. � Cu. Ft /..... ..-1.
Front........................ Depth .... ................. .. Height ........................ Sq. Ft......................... Cu. Ft.........................
01-V
Type of Consttion ........................................................... Est. Cost...L. �...1. L...®1........'........ To be Completed ............................................. _........
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. _ —40t..
In consideration of thea
p yment of a fee of $ .......................... permit is hereby granted
...... __.... -._................................................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _ -1' 10
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
Application for Power Plants and. Heating. Cooling. Ventilation, .ReM9erce m and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL,
V
Furnace Shell & Duct Work .......................... 8.00 $
Replacement of Furnace ............................. 5.00 $
Repairs & Alterations—up to $500.00 .................. 5.00 $
Repairs & Alterations each add. $500.00 ............... 2.50 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00
�y
each add. 60,000 BTU ........................ 2.00 $
Replacement of Furnace ............................. §.00 $
Repairs & Alterations—up to $500.00 .... ............ 5.00 $
Repairs & Alterations each add. $500.00 ....... :...... 2.50 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam.......
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ............. '.........
2.50
$
Each add. 320 sq. ft. EDR Hot Water ..................
2.50
$
OIL BURNER—to 3 gal, per hour ........................ 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTL) ....................... 5.00 $ –5-, ® to
GAS FITTING FEES: NO RATE TOTAL
t 1st 3 Fixtures..... x $1.50 $
.................
Additional Fixtures ................. x .50 $
" Gas Range to 200,000 BTU ........... x 2.00 $
AIR CONDITIONING $ /'116-0
FAN DATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL FEE
ROUGH
FINAL
Dept. of Bldgs. Phone SII. 4-7470
Location
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley,
Owner X-2; 4-1 .N
Kind of Building
Used as
To be completed about
00
Estimated Cost, $ O
Old—tee Building Permit No. (J Permit No. -
DESCRIPTION OF WORK
HEATING or POWER steam, Hot Water, Warm Air—No_
Trade Name '0!5��d ® Size No-�.��Ap
Capacity l/�;
Sq. Ft. E.D.R BTU 0'00
lvuP.
Total Connected Load �!"?9 .2– Kind of Fuel 4'&-1 5
BURNER — Trade NameB A1,0 h✓/ v-4 Al- Size No
Capacity Sq. Ft. E.D.R BTU J� A H.P.
(REMARKS -OVER)
Signe Z 1 • tloe! -
��,-42 2N 7.59 Business Phone No
nss
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOUS.
Weatherstripsuide A.S.H. e.E. Construction No. Insulation
G
'` Windows ,', ( Doors Reference Out. Wall I Int. Wall ICeiling I Roof Floor Kind How Applies
e No es No 19— / iA'7' •t
F1.1 W rRoom Length /;? Width Height / FU rj ,: i � Room Length Width I %.—Height
Windows and Doors—Crackage and Area
/y ,{i
Width Height No. o! Lineal ft. Area
No. of pane of pane tights o! crack sq. it.
Coef.
16 /
i.
Net exp. wall
11
y
Coef.1 Btu
Coef. Btu
Infiltration
Glass
,s'I„o 0
�
3
-S-0
Exp. wall
.3o it
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Net exp., wall
' j 33
Int. wall
Ceilin
Floor , .
% // '
.�` 37—
/ 0
Total Btu. I x Z. 10
P Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
I FU AP -A P -1 Room I Length l A Width +' Height AA
Windows and Doors--Crackage and Area
/y ,{i
Width Height No. of Lineal Lt Area
No. of pane of pane lights of track sq. ft..
Coef.
Infiltration
Glass
Exp. wall _33 03
i.
Net exp. wall
11
y
Coef.1 Btu
Infiltration
Glass '
Ceiling
,s'I„o 0
Exp. wall
.. x
Total Btu.
Net exp.wall
Int. wall
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Ceiling
Floor
1.3 v 3
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
F1.1 ry L- Room I Length 13 Width 10
Windows and Doors—Crackage and Area
width Helght No. oL Linealft Area
No. of Dane of pane lights of crack sq. tt.
7
2 -
Btu
Infiltration`J 5
Glass tr
Exp. wall o r'
Net expwall r"
Int. wall
Ceiling
Floor / 3 'e' D
Tbtal Btu. & f s./
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
width Height No. o! Lineal tt. Area
No. of pane of pane lights o! crank eq. it.
2- 'z—
_®
/y ,{i
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack O.Q. ft.
Coef.
Infiltration
Glass
Exp. wall _33 03
39
4,u
Net exp. wall
11
y
Int. wall
7 it¢ i
Ceiling
Ceiling
Floor 21
Total Btu.
x
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Btu
i FLI Rnami I Length -% Width a Heiaht f/
Windows and Doors—Crackage and Area
1
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack O.Q. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
7 it¢ i
Z -
Ceiling
Floor
x
y.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area I
F1.1 '" Room I Length Width Height
Windows and Doors—Crackage and Area
Wldtb Helght No of Lineal tt Area
Na of pane ot•pane Ilg s of creek eq. tt.
16 4-17i i j C'
Btu I
Infiltration ?
Glass
Exp. wall
Net exp. wall �;1►
Int. wall
Ceiling
Floor z 1___/ "t-- t;-
Total Btu. �i t
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
City of Fridley, Minn.
BUILDING PERMIT zx/u (:4 819
...._........V--n�tze---- .Date: ......... ...__
F
Owner: Builder
Address 4°M """ �� Address
OF BUILDING
Part of Lot _ ._._._.._.._ .
�
Lot .'�-... Block ... _.......... ........... Addition or Sub -Di on .......... ....�..fi"z..-�_.._._...__..._
Corner Lot ....._---.. ......... Inside Lot ...__ ......................_.._.... Stback ' ` _ Side ......................
SewerElevation ............ _.................... .................... ..._................:_.............._._ Fodation Elevation ...... _............ ............
DESCRIPTION OF BUILDING
To a Used as:
P .. Height ......,� .. Sq. Ft. `r`c Cu. Ft..o+i+�
Front _. ...._..
Deth ..... ...........-
..... .............. ................ ...... -.............. Front ............. Depth Est. Cost. ...................._.. ei ht ....._........... - Sq.
Type of Construction Jt. ..... - ........... .._.. Cu. Ft. .................... -
.: !'�' �` °... To be Completed ........................... ..._......._........
......—�^�.��J�,.
� iD �O
10N °FAN EZS�R\C�\G�s°
BU\Ep\I\G
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work In accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $.... '"""....., permit is hereby granted to. ... _.................................... _..........
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom ;it is. granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violati of any of the provisions of said
ordinances.'`'
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, XMNESOTA
Owners Name PA &A; [a R, mr, ig Builder
Address V e ` cam' .1, G' Address�fQC�:) Q dV (F
LOCATION OF
No. e ® Street �° � �;� - . _P 't of Lot
Lot Block. -,-, a Addition or Sub.D
Corner Lot4e�side Lot Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
/ -Y - --- Front 2 0 .,Depth__Z.! . Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft,
a
Type of Construction �'�,®.64 Estimated cost -=7
To be
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the facts and representa-
tions stated in this application are true and correct.
DATE �S' -- / K' In ® SIGNATURE IPot�l
(A Schedule of Fee costs can be found on the Reverse Side.)
0 0
PIA
3
h®vso
®0 s;
0
City of Fridley, Minn.
•
MEWING PERMIT
Date: May25s 1965
Maxie Barker
C'N"ar'
Address 5500 3rd. Street N. E-
� 6--7
W? '7541
Cobb Inc.
Builder
Address P. 0. Box 2647 New Brighton, Minn•
LOCATION OF BUILDING
No. 5500 Street ?rd- Street N. E_ Part of Lot
Lot 14, 15 —Block 22 Addition or Sub -Division . _EM PERE
Corner Lot _ Inside Lot __ _ Setback __._ Sideyard
Sewer Elevation
To be Used as:
Front
Front
Type of Construction
Foundation Elevation
DESCRIPTION OF BUILDING
Depth Height Sq. Ft. Cu. Ft.
Depth Height Sq. Ft. Cu. Ft.
____ Fst. Cost -" 0 _ To be Completed
• Repair Storm. Damage: Roofing, Siding
In consideration of the issuance to me of a permit to construct the building cri hove, I
the proposed work in accordance with the description above aet� forth%�
oniiaenoas oP the city of Fridley.
10,00! Cobb Inc.
In consideration of the payment of a fee of 2 ' ,permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the e�tpress condition that the person to whom it is granted and his agents, employees and workmen, in all work
k
,to the ordinances of
, moving of buildings
the provisions of
dty ]imita� permit may be revoked at any time upon violation of any of said
NOTICE:
Me pwmh don no carer the condracow, hulaWen for whits, plumbing, on hafts, swwr or water. Be wre to as
the Building Wwader for aparate permih for d"" keno.
rj
i
JAPPLICATION FORAwc°PERMIT
CITY OF FRIDLEY6 °LNESOTA
.. 4
C �
OWNER'S NAME Q BUILDER el/5 /91
,. � %
ADDRESS`S%�a T _ ADDitESS ,e e° �742� .
LOCATION OF BUMDING.
No, Street Part o£ ' Lot .
Lot' �- / �Block - Additiot r . or Subd1vi0i. �&,�_
Corner Lot Inside Lot _.,.Set.back Side Yard.
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to thit form, Two Certificates of Survey of Lot and proposed build—
Ing location drivn on these CA-ttificates . �
DESCRIPTION OF BUILDING
lYe be used as:
• d
Front Depth height;
Sq. Ft. Cu. Ft.
Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost
The undersigned hereby makes application for a .permit for the work herein specified,
agreeing to coo all work iit strict accordance with the City of Fridley Ordinances and
rulings if the Department"of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
fSchedule'.of Fee Costs can be found on the Reverse Side).
CITY OF FRIDLEY Effective Date May 1, 1988
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
1�
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Furnace Shell and Duct Work,
Burner (Also replacement furnace)
$ 20.00
$
Gas Piping
$ 10.00
$
(piping needed with new furnace)
Gas Range
Gas Dryer
$ 10.00
$
* Air Conditioning (all sizes)
$ 10.00
$ 0
T�—
All Others/Repairs and Alterations
18 of value of Appliance or Work
$
COMMERCIAL/INDUSTRIAL
18 of value of Appliance or Work
State Surcharge
TOTAL FEE
Reinspection Fee ($15.00)
Rough Insp.
Date
Final Insp.
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00,
PLUS $.50 STATE SURCHARGE
$ .50
�vfa/
Attach stack verification form with replacement furnace permits
*Air Conditioners can not be placed in side yard without
written permission from adjoining neighbor.
Job Address
f
Department of Buildings, 6431 University Ave. N.E., Fridley; MN 55432
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance':with the City Codes
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are
,true and correct.
l Minn.OWNER '/ zZ
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air= N&.`
Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Total Connected Load Kind of Fuel`
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
Company NStandard -`Heating & ASC
Signed By
Tel. No. 824-2656 °`
SUBJECT
City of Fridley
TEO.
216
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
�� J
r PROTECTIVE INSPECTION SEC.
t �
`
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/3/81
F/
JOB ADDRESS 5580,0 -,3rd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
14,15
22
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mildred Barker 5800 - 3rd Street N.E. 571-3635
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO,
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION rI ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install aluminum siding and trim
8 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$4,OQ0
$2.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$24.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$ 26.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI;=Lmg
ERLY VALIDATED THIS IS YOUR PERMIT
w
BLDG INSP i DATE
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
CITY OF FRIDLEY
APPLICATIOJ FOR RESIDLNTIAL BUILDING PERMITS
(New, Alterations, /additions, or Repairs)
OWNER:
ADDRESS: 5 900 — -3 R� 57./V C
TEL No: _6' %/ -.3*63 r
STRMT NO: U 6
Al /�"/L-*
r-o n1 ..J 0 ///V so -J
ADDRESS: eeou 7-11A L.
TEL 110: %g/— ES 'if
Construction Location
STREET: 3 Q ,
LOT: BLOCK: ADJ)ITION :
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION -
Front:
Square. Feet:
Depth: Height:
Cubic Feet:
Front: Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: Estimated Cost: $ �D O 0 -
To $e Cbripleted: .
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET
Mie undersigned hereby makes application for a permit for the t:;ork'herein specified,
agreeing to do.all work in strict accordance with the City of Fridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE: —4 - 3 — X1 SIGNATURE XIN--�
Stipulations:
�0
Q
SUBJECT
P
City of Fridley
22151
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
i
_
V "��
fr PROTECTIVE INSPECTION SEC.
��
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/1/93
JOB ADDRESS 5800 3 St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
14,15
22
Hyde Park SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mildred Barker 5800 3 St NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Zahorski Construction 3246 Emerson Ave N, Mpls., MN 55412 529-6799 8902
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House (15 Sqs) Tear --off
9 CHANGE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code. Provide adequate
attic ventilation. Provide smoke detectors as per 1210 adjacent to all sleeping
areas and in basement.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,600
$.80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$37.00
Fire SC $1.60
STUCTION OR THE PERFORMANCE F CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$44.40
SIGNATURE OF CONTR CTCR OR AUTHORIZED AGENT IOATEI
W P O LY VALIDATED THIS IS YOUR PERMIT
' EL DG INSP gaTE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
NEW [ ] Effective 5/26/93
ADDN [ ] CITY OF FRIDLEY
ALTER { ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 j o
Building Permit Application
Construction Address: 57900 3 rcQ :S, 9E
E
Legal Description: L ) Lt - (5 hoc k: Hf G�
Owner Name & Address: f \ cv�p-C-k BC, v k r Tel. 15- -7 35
Contractor: —7-C'ho; `� C�o r�S�c �.c ;� r� MN LICENSE # Co O �Ioo�
Address: -3 ? LI (, VU119 (' Sc r1 %� U ��JAS �'i -55'0— Tel. # 5,49-
LIVING AREA: Length
GARAGE AREA: Length
DECK AREA: Length
OTHER:
Attach to this application, a Certificate of Survey of the
K with the proposed construction drawn on it to scale.
DESCRIPTION OF H"ROVEMENT
Width Height Sq. Ft.
Width Height
Width Hgt/Ground
se
-QL (- o
Sq. Ft.
Sq. Ft.
Corner Lot [ J inside Lar { ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: R co t+L) Estimated Cost: $ L (D (90, 6 C)
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: ` '�o-9 -3 APPLICANT: �Tel. if 7? %
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ -2 9, OCA,
$ 160
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$ - 6 0 $.50/$1,000 Valuation
$ $750 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ Conservation Plan Review $450.00
$ Fee Determined by Engineering
$ Agreement Nary [ ] Not Necessary [ ]
$ ` STIPULATIONS:
Building.
Inspedions
1763-572-3604
DATE /— 7— o
SITE ADDRESS !& DO
THIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
E-MAIL ADDRESS
OWNER ❑CONTRACTOR
Permit No.
Received By:
Date Rec'd:
PROPERTY OWNER/
NAME: �L
��P
$
TENANT
r
yam^ ?U4 f& UZ46
IP Z
ADDRESS: 7 0O, j1 S/' CITY
$
STATE .sTy3
-Z
PHONE:� a ?q
—
i CONTRACTOR
C
NAME: 7 Z:2 r—
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY
STATE—ZIP
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
JKWINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: -24
SIZE OF RAPROVEMENT LENGTH
WIDTH
HEIGHT Sq. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum ❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
AT T VV'Fc AUV RACED nN VAT.TTATTnN_ TNCT.TTDTNG THF, COST OF LABOR
AND MATERIALS:
TOTAL JOB VALUATION
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
THE 1997 U.B.0 FEE SCHEDULE)
,)�,tn6 OCCUPANC'
$
$
$
.7G>
$
-Z
$
—
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME/o� Z DATE�� / ' 6
I tin qY'A"Ti
EWER
Rs 0
A�1
A
91
Building
BUILDING
Permit No.. (��
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date;gtl: Irl �oo
763-502-4977 FAX
EFFECTIVE 1-1-09
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: v- ' y e,_2< -g
TENANT
ADDRESS: 5-.3w Y'rlCITY Y' � 'e—
ZIP S5
PHONE:'? to 3 — T2'9
-STATER
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE—ZIP—
TATEZIPINSURANCE
INSURANCE
PHONE FAX
PROPERTY TYPE
19 SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES_
PERMIT TYPE
❑ ADDITION 9 GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH 61ROOF ❑ DRAIN TILE
❑ DECK 0 SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:,/, S� _ l YN!c1
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
13 HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
l,Vinyl
Idsoffit
ADDITIONS_ & PORCHES SUBMIT:
❑ Aluminum
64 Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
Fascia
and proposed project.
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SING THE 1997 U.B.0 FEE SCHEDULE)
'OTAL JOB VALUATION $ b6 , CRD OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for, permit and work is not to start without a per{nit on site; that the work will be in accordance with the
approved plan in the case o all workpvhic res review and approval of p S. ,\\
SIGNATURE OF APPLICANT PRINT NAME Q ATE Q
498272.001
&VOW' " — QUIT CLAIM DEED (Top 3 inches Reserved for Recordiog Dam) - Mrl AWA b Co. ° St Poul, MN 981-842.1888
IndividnXs) to Joint Tenants Nhmwm unffi m Qnvayaoft» tuur9'r)
DEED TIff DUB:
FOR VALUABLE CONSMERAMN, x4mll Mika, -i 16t 4-AlLm
r, hereby con and gnitcl:rims toy i dLA W1 I I W i i� I CIA J M .l I� c —
ICtd
Grantees, as joint tem, real property in _ County, Minnesota, desmbed as follows:
5800 v3RC- 47f -Ate , FKId l,A'A i M & -34
LC al cte3cf0� - F -IJ
blocK
00--nSICWia-fic-n IU 'bx U55 41'lan4--T)O."
together with all hereditaments and appurtenances.
k box if applicable:
The Seller certifies that the seller does not know of any wells on the. described real property.
❑ A well disclosure certificate accompanies this document.
❑ I am flumb r with the property described in this instrument and I certify that the status and number of wells on
the described real property have not changed since the last previously filed well disclosure certificate.
i
° Affix Deed Tax Stamp Here
STATE OF MDMSCa An Ipra
} s:
COUNTY OF
This instrlrment was acknowledged before me on
1yik k QUA UA nam
1
NOTAWAL STANIP ox .`t8atrap T117& oaR&-M
w• r�
stoNATTRta op NoTAqoFpucoa ooTmm omaAL fit
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deck hire if part or the laid is ❑ Z"
Tax amtemmm for the real property desuibcd to this hrsrtmneot should
=
be seat to (include name and address of ortmtse):
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hTLL
A/E.
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un�a� butt
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COVE= eP TMS FOM PROMMM.
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